Association of Snacking Frequency,Size, and Energy Density with Weight Status among Preschool-Aged Children in the United States

BackgroundSnacking (ie, eating between meals) is common among US preschool-aged children, but associations with weight status are unclear.ObjectiveThis research evaluated associations of snack frequency, size, and energy density as well as the percent of daily energy from snacking with weight status and sociodemographic characteristics among US children aged 2 to 5 years.DesignCross-sectional analysis of 2007-2018 National Health and Nutrition Examination Survey data using two, caregiver proxy, 24-hour dietary recalls.Participants/settingUS children aged 2 to 5 years (n = 3,313) with at least one snack occasion over 2 days of intake.Main outcome measuresSnacking parameters included frequency (number of occasions per day), size (kilocalories per occasion), and energy density (kilocalories per gram per occasion) as well as percent of daily energy from snacking.Statistical analysesGeneralized linear regression models evaluated associations of snacking with child weight status (ie, normal weight and overweight/obesity), adjusting for survey weights, energy misreporting, mean meal size, and sociodemographic covariates.ResultsChildren with overweight/obesity consumed more frequent snacks (2.8 [0.06] vs 2.5 [0.03] snacks/day, respectively; P < 0.001), larger snacks (188 [4] vs 162 [23] kcal/occasion, respectively; P < 0.001), and a greater percent of daily energy from snacking (29.80% [1.00%] vs 26.09% [0.40%], respectively; P < 0.001) than children with normal weight. Mean snack frequency and size as well as percentage of daily energy from snacking varied with child age, gender, and head of household education. Associations of snacking with child race and ethnicity were less consistent.ConclusionsThese nationally representative findings provide evidence that the consumption of larger, more frequent snacks is associated with overweight/obesity among US children aged 2 to 5 years and snacking varies by sociodemographic characteristics.     

Oral Health Status of Children and Adolescents by Rural Residence, United States

CONTEXT: The limited information available on the oral health status of rural children in the United States makes it difficult to devise policy strategies to address perceived problems. PURPOSE: To document the oral health status and dental care utilization of US children by place of residence, METHODS: Data from National Health Interview Surveys for 1995, 1997, and 1998, and from the third National Health and Nutrition Examination Survey (1988-1994) were analyzed. FINDINGS: Children residing in rural areas were more likely to be uninsured for dental care than were children from urban areas (41.1% versus 34.7%). A greater percentage of rural than urban children reported unmet dental needs (7.5% versus 5.6%); there was no difference in self-reported poor dental status. Urban children were more likely than rural children to have visited the dentist in the past year (73.6% versus 69.9%) and were also more likely to be regular users of dental care (61.7% versus 51.4%). Differences in percentage of rural and urban children with caries lesions and caries experience were not significant. CONCLUSIONS: Children residing in rural areas have less access to and utilization of dental care compared to children residing in urban areas. Moreover, poor rural children display less utilization of dental services than poor urban children. Differences in the sum of decayed and filled primary teeth and the sum of decayed, missing, and filled permanent teeth were not significant.     

The Current Status of Medical Marijuana in the United States

Medical marijuana is currently a controversial issue in medicine. There are strong pro and con opinions but relatively little scientific data on which to base medical decisions. The unfortunate scheduling of marijuana in class I has limited research and only serves to fuel the controversy.This article will review the history of laws to regulate drugs in the United States in the 20th century to provide context for the current status of medical marijuana.It will include the rationale for opposing medical marijuana laws and the problem of the Schedule I inclusion of marijuana as well as other drugs. It will examine the problems associated with smoking raw marijuana and review other routes of administration.Finally, it examines the inadvisability of medicine''s promotion of smoked marijuana.     

Hydration Status in the United States and Germany

In the United States and Germany, population groups show distinct differences in water metabolism. A higher intake of preformed water (fluids and food moisture) and a higher urinary volume hint towards a more favorable hydration status of the American than the German population. In the United States, the Adequate Intake for preformed water is set based on the median preformed water intake from US survey data. In Germany, physiologically founded and empirically based Guiding Values are proposed. The recommended intake of preformed and metabolic water related to energy intake ranges from 1.01 to 1.08 mL/kcal in German adults and from 1.21 to 1.31 mL/kcal in American adults.     

Estimated Number of Preterm Births and Low Birth Weight Children Born in the United States Due to Maternal Binge Drinking

The objective of this study was to estimate the aggregate burden of maternal binge drinking on preterm birth (PTB) and low birth weight (LBW) across American sociodemographic groups in 2008. To estimate the aggregate burden of maternal binge drinking on preterm birth (PTB) and low birth weight (LBW) across American sociodemographic groups in 2008. A simulation model was developed to estimate the number of PTB and LBW cases due to maternal binge drinking. Data inputs for the model included number of births and rates of preterm and LBW from the National Center for Health Statistics; female population by childbearing age groups from the U.S. Census; increased relative risks of preterm and LBW deliveries due to maternal binge drinking extracted from the literature; and adjusted prevalence of binge drinking among pregnant women estimated in a multivariate logistic regression model using Behavioral Risk Factor Surveillance System survey. The most conservative estimates attributed maternal binge drinking to 8,701 (95 % CI: 7,804–9,598) PTBs (1.75 % of all PTBs) and 5,627 (95 % CI 5,121–6,133) LBW deliveries in 2008, with 3,708 (95 % CI: 3,375–4,041) cases of both PTB and LBW. The estimated rate of PTB due to maternal binge drinking was 1.57 % among all PTBs to White women, 0.69 % among Black women, 3.31 % among Hispanic women, and 2.35 % among other races. Compared to other age groups, women ages 40–44 had the highest adjusted binge drinking rate and highest PTB rate due to maternal binge drinking (4.33 %). Maternal binge drinking contributed significantly to PTB and LBW differentially across sociodemographic groups.     

Weight gain trends across sociodemographic groups in the United States

OBJECTIVES: To better understand health disparities, we compared US weight gain trends across sociodemographic groups between 1986 and 2002. METHODS: We analyzed mean and 80th-percentile body mass index (BMI), calculated from self-reported weight and height, for subpopulations defined by education, relative income, race/ethnicity, and gender. Data were from the Behavioral Risk Factor Surveillance System, a random-digit-dialed telephone survey (total sample=1.88 million adult respondents). RESULTS: Each sociodemographic group experienced generally similar weight gains. We found no statistically significant difference in increase in mean BMI by educational attainment, except that individuals with a college degree gained less weight than did others. The lowest-income group gained as much weight on average as the highest-income group, but lowest-income heavier individuals (80th percentile of BMI) gained weight faster than highest-income heavier individuals. We found no differences across racial/ethnic groups except that non-Hispanic Blacks gained more weight than other groups. Women gained more weight than men. CONCLUSIONS: We found fewer differences, especially by relative income and education, in weight gain across subpopulations than we had expected. Women and non-Hispanic Blacks gained weight faster than other groups.     

The Alternative Birth Movement in the United States: History and Current Status

The alternative birth movement is a consumer reaction to paternalistic and mechanistic medical obstetrical practices which developed in the United States early in this century. Alternative birth settings developed as single labor-delivery-recovery rooms in the hospital or as free-standing birth centers. Both alternatives offer family-centered, home-like, low technological maternity care. In order to overcome physician resistance to non-traditional maternity care, alternative birth center policies eliminate all women who are expected to have a complicated pregnancy or delivery. Physician resistance to alternative birthing is publicly based on the issue of maternal and infant safety. Additional issues, however, are that physicians fear economic competition and resist loss of control over obstetric practice. This paper (1) traces the historical antecedents and social factors leading to the alternative birth movement, (2) describes the types of alternative birthing methods, and (3) describes ways in which the obstetrical community has maintained and rationalized dominance over the birthing process.     

美国医疗器械工业发展状况

１９９３年，美国商务部声明，美国医疗器械产品在世界范围内的销售额达４２０亿美元，与１９９２ 年相比，增长了５．８％。这一增长率再次说明，医疗器械工业成为美国经济发展的重要行业之一。 １９９５年，经ＦＤＡ注册的医疗器械制造商多达 １０ ３５５家。其中，加利福尼亚州的医疗器械制造商为１９２０家，是纽约的２倍以上；仅次于这两个州的是伊利诺斯州，有６２０家，马塞诸塞州有５６７家、佛罗里达与得克萨斯各有４８３家。这６个州的医疗器械制造商总数占全美国已注册医疗器械制造商总数的５０％。总之，医疗器械工业对美国医疗…